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            "abstractNote": "Objective The authors examined the changing patterns of mood before and after an Ironman triathlon, and the relationships between expected performance outcomes, perception of effort and pacing.\nDesign Twelve participants in the 2008 Ironman Austria triathlon competition were studied before, during and after the event. Each participant completed measures of mood, anxiety and perceived exertion, while pacing was calculated from official race timings at various points on the course.\nResults Positive correlations were found between distance covered and rating of perceived exertion (RPE) during each of the individual disciplines, and also between RPE and the percentage of overall race time completed (r=0.826, p<0.001). A negative correlation was found between average speed and distance covered during the run segment (r=−0.911, p<0.005) with pace gradually declining. Differences occurred in the profile of mood states mood subscales of tension and fatigue between the baseline, prerace and postrace trials. Somatic anxiety was higher before the race compared with baseline measures.\nDiscussion RPE followed a linear progression of RPE during each discipline followed by a re-setting of the perception of effort at the start of the next discipline. The increase in RPE for the entire event followed a linear increase. The linear decline in run pace is consistent with a recent model in which expected RPE is used to modulate pacing. Anxiety and mood responses of participants in this study indicate that the emotional response of athletes before and after ultra-endurance exercise is closely aligned with their conscious thoughts.",
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            "title": "THE INCIDENCE, IMPORTANCE, AND PROPHYLAXIS OF ACUTE MOUNTAIN SICKNESS",
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                    "firstName": "PeterH.",
                    "lastName": "Hackett"
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                    "firstName": "Drummond",
                    "lastName": "Rennie"
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            "abstractNote": "Acute mountain sickness (A.M.S.) and its severe complications, high-altitude pulmonary oedema (H.A.P.O.) and cerebral oedema (c.o.), were studied in 278 unacclimatised hikers at 4243 m altitude at Pheriche in the Himalayas of Nepal. The overall incidence of A.M.S. was 53%, the incidence being increased in the young and in those who flew to 2800 m, climbed fast, and spent fewer nights acclimatising en route. It was unrelated to sex, to previous altitude experience, to the load carried, and to recent respiratory infections. The severity of A.M.S. was inversely related to age (independent of rate of ascent) and the highest altitude attained, and was highly correlated with speed of ascent. There were 7 cases of H.A.P.O. and 5 with the more intractable c.o. and, of these 12, 11 had flown in, 9 had spent only one night at Pheriche, and none were on acetazolamide. 11 required evacuation. Acetazolamide, compared in a double-blind study with a placebo and also compared with no tablets at all, reduced both the incidence and the severity of A.M.S. in those who flew to 2800 m but not in those who hiked up to that altitude. Prevention consists in slow ascent, rapid recognition of warning signs, and prompt descent to avoid progression.",
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